-soup
nature, with a very offensive odor. Constipation throughout the
disease is, however, not uncommon in the more serious cases. The pulse
ranges from 80 to 120 a minute.

During the third week, in cases of moderate severity, the general
condition begins to improve with lowering of the temperature, clearing
of the tongue, and less frequent bowel movements. But in severe cases
the patient becomes weaker, with rapid, feeble pulse, ranging from 120
to 140; stupor and muttering delirium; twitching of the wrists and
picking at the bedclothes, with general trembling of the muscles in
moving; slow, hesitating speech, and emaciation; while the urine and
faeces may be passed unconsciously in bed. Occasionally the patient
with delirium may require watching to prevent him from getting out of
bed and injuring himself. He may appear insane.

During the fourth week, in favorable cases, the temperature falls to
normal in the morning, the pulse is reduced to 80 or 100, the diarrhea
ceases, and natural sleep returns.

Among the many and frequent variations from the type described, there
may be a fever prolonged for five or six weeks, with a good recovery.
Chills are not uncommon during the disease, sometimes owing to
complications. Relapse, or a return of the fever and other symptoms
all over again, occurs in about ten per cent of the cases. This may
happen more than once, and as many as five relapses have been recorded
in one patient. A slight return of the fever for a day or two is often
seen, owing to error in diet, excitement, or other imprudence after
apparent recovery. Death may occur at any time from the first week,
owing to complications or the action of the poison of the disease.
Pneumonia, perforation of and bleeding from the bowels are the most
frequent dangerous complications. Unfavorable symptoms are continued
high fever (105 deg. to 106 deg. F.), marked delirium, and trembling of the
muscles in early stages, and bleeding from the bowels; also intense
and sudden pain with vomiting, indicating perforation of the
intestines. The result is more apt to prove unfavorable in very fat
patients, and especially so in persons who have walked about until the
fever has become pronounced. Bleeding from the bowels occurs in four
to six per cent of all cases and is responsible for fifteen per cent
of the deaths; perforation of the bowels happens in one to two per
cent of all cases and occasions ten per cent of the deaths.

=Detecti